Development of a Gait Rehabilitation Robot Using an Exoskeleton and Functional Electrical Stimulation: Validation in a Pseudo-paraplegic Model.

ABSTRACT

OBJECTIVE: We have developed a robot for gait rehabilitation of paraplegics for use in combination with functional electrical stimulation (FES). The purpose of this study was to verify whether the robot-derived torque can be reduced by using FES in a healthy-person pseudo-paraplegic model. METHODS: Nine healthy participants (22-36 years old) participated in this study. The robot exoskeleton was designed based on the hip-knee-ankle-foot orthosis for paraplegia. Participants walked on a treadmill using a rehabilitation lift to support their weight. The bilateral quadriceps femoris and hamstrings were stimulated using FES. The participants walked both with and without FES, and two walking speeds, 0.8 and 1.2 km/h, were used. Participants walked for 1 min in each of the four conditions (a) 0.8 km/h without FES, (b) 0.8 km/h with FES, (c) 1.2 km/h without FES, and (d) 1.2 km/h with FES. The required robot torques in these conditions were compared for each hip and knee joint. The maximum torque was compared using one-way analysis of variance to determine whether there was a difference in the amount of assist torque for each gait cycle. RESULTS: Walking with the exoskeleton robot in combination with FES significantly reduced the torque in hip and knee joints, except for the right hip during extension. CONCLUSIONS: In the healthy-participant pseudo-paraplegic model, walking with FES showed a reduction in the robot-derived torque at both the hip and knee joints. Our rehabilitation robot combined with FES has the potential to assist paraplegics with various degrees of muscle weakness and thereby provide effective rehabilitation.